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Dietary Recommendations for Adults With Psoriasis or Psoriatic Arthritis From the Medical Board of the National Psoriasis Foundation: A Systematic Review.
JAMA Dermatol. 2018 Aug 01; 154(8):934-950.JD

Abstract

Importance

Psoriasis is a chronic, inflammatory skin disease and has significant associated morbidity and effect on quality of life. It is important to determine whether dietary interventions help reduce disease severity in patients with psoriatic diseases.

Objective

To make evidence-based dietary recommendations for adults with psoriasis and/or psoriatic arthritis from the Medical Board of the National Psoriasis Foundation.

Evidence Review

We used literature from prior systematic reviews as well as additional primary literature from the MEDLINE database from January 1, 2014, to August 31, 2017, that evaluated the impact of diet on psoriasis. We included observational and interventional studies of patients with psoriasis or psoriatic arthritis. The quality of included studies was assessed using the Newcastle-Ottawa scale for observational studies and the Cochrane Risk of Bias Tool for interventional studies. We made evidence-based dietary recommendations, which were voted on by the National Psoriasis Foundation Medical Board.

Findings

We identified 55 studies meeting the inclusion criteria for this review. These studies represent 77 557 unique participants of which 4534 have psoriasis. Based on the literature, we strongly recommend dietary weight reduction with a hypocaloric diet in overweight and obese patients with psoriasis. We weakly recommend a gluten-free diet only in patients who test positive for serologic markers of gluten sensitivity. Based on low-quality data, select foods, nutrients, and dietary patterns may affect psoriasis. For patients with psoriatic arthritis, we weakly recommend vitamin D supplementation and dietary weight reduction with a hypocaloric diet in overweight and obese patients. Dietary interventions should always be used in conjunction with standard medical therapies for psoriasis and psoriatic arthritis.

Conclusions and Relevance

Adults with psoriasis and/or psoriatic arthritis can supplement their standard medical therapies with dietary interventions to reduce disease severity. These dietary recommendations from the National Psoriasis Foundation Medical Board will help guide clinicians regarding the utility of dietary interventions in adults with psoriatic diseases.

Authors+Show Affiliations

Keck School of Medicine, University of Southern California, Los Angeles.National Psoriasis Foundation, Portland, Oregon.Psoriasis Treatment Center of Central New Jersey, East Windsor.Department of Dermatology, University of California San Francisco. Department of Pediatrics, University of California San Francisco.Department of Dermatology, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York.New York Medical College at Metropolitan Hospital, New York. Hudson Dermatology, Somers, New York.Department of Dermatology, George Washington University School of Medicine, Washington, DC.Department of Dermatology, University of Michigan, Ann Arbor.Department of Dermatology, University of California San Francisco.Icahn School of Medicine at Mount Sinai, New York, New York.Department of Dermatology, University of California San Francisco.Northwestern University Feinberg School of Medicine, Chicago, Illinois.Hospital for Special Surgery, Weill Medical College of Cornell University, New York-Presbyterian Hospital, New York.National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.Brigham and Women's Hospital, Harvard University, Boston, Massachusetts.Department of Dermatology, George Washington University School of Medicine, Washington, DC.Blackrock Clinic, Dublin, Ireland.Hospital for Special Surgery, Weill Medical College of Cornell University, New York-Presbyterian Hospital, New York.Arthritis and Rheumatism Associates, PC, Rockville, Maryland. Georgetown University School of Medicine, Washington, DC.Department of Dermatology, Eastern Virginia Medical School, Norfolk.Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California.Keck School of Medicine, University of Southern California, Los Angeles.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Systematic Review

Language

eng

PubMed ID

29926091

Citation

Ford, Adam R., et al. "Dietary Recommendations for Adults With Psoriasis or Psoriatic Arthritis From the Medical Board of the National Psoriasis Foundation: a Systematic Review." JAMA Dermatology, vol. 154, no. 8, 2018, pp. 934-950.
Ford AR, Siegel M, Bagel J, et al. Dietary Recommendations for Adults With Psoriasis or Psoriatic Arthritis From the Medical Board of the National Psoriasis Foundation: A Systematic Review. JAMA Dermatol. 2018;154(8):934-950.
Ford, A. R., Siegel, M., Bagel, J., Cordoro, K. M., Garg, A., Gottlieb, A., Green, L. J., Gudjonsson, J. E., Koo, J., Lebwohl, M., Liao, W., Mandelin, A. M., Markenson, J. A., Mehta, N., Merola, J. F., Prussick, R., Ryan, C., Schwartzman, S., Siegel, E. L., ... Armstrong, A. W. (2018). Dietary Recommendations for Adults With Psoriasis or Psoriatic Arthritis From the Medical Board of the National Psoriasis Foundation: A Systematic Review. JAMA Dermatology, 154(8), 934-950. https://doi.org/10.1001/jamadermatol.2018.1412
Ford AR, et al. Dietary Recommendations for Adults With Psoriasis or Psoriatic Arthritis From the Medical Board of the National Psoriasis Foundation: a Systematic Review. JAMA Dermatol. 2018 08 1;154(8):934-950. PubMed PMID: 29926091.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dietary Recommendations for Adults With Psoriasis or Psoriatic Arthritis From the Medical Board of the National Psoriasis Foundation: A Systematic Review. AU - Ford,Adam R, AU - Siegel,Michael, AU - Bagel,Jerry, AU - Cordoro,Kelly M, AU - Garg,Amit, AU - Gottlieb,Alice, AU - Green,Lawrence J, AU - Gudjonsson,Johann E, AU - Koo,John, AU - Lebwohl,Mark, AU - Liao,Wilson, AU - Mandelin,Arthur M,2nd AU - Markenson,Joseph A, AU - Mehta,Nehal, AU - Merola,Joseph F, AU - Prussick,Ronald, AU - Ryan,Caitriona, AU - Schwartzman,Sergio, AU - Siegel,Evan L, AU - Van Voorhees,Abby S, AU - Wu,Jashin J, AU - Armstrong,April W, PY - 2018/6/22/pubmed PY - 2019/9/11/medline PY - 2018/6/22/entrez SP - 934 EP - 950 JF - JAMA dermatology JO - JAMA Dermatol VL - 154 IS - 8 N2 - Importance: Psoriasis is a chronic, inflammatory skin disease and has significant associated morbidity and effect on quality of life. It is important to determine whether dietary interventions help reduce disease severity in patients with psoriatic diseases. Objective: To make evidence-based dietary recommendations for adults with psoriasis and/or psoriatic arthritis from the Medical Board of the National Psoriasis Foundation. Evidence Review: We used literature from prior systematic reviews as well as additional primary literature from the MEDLINE database from January 1, 2014, to August 31, 2017, that evaluated the impact of diet on psoriasis. We included observational and interventional studies of patients with psoriasis or psoriatic arthritis. The quality of included studies was assessed using the Newcastle-Ottawa scale for observational studies and the Cochrane Risk of Bias Tool for interventional studies. We made evidence-based dietary recommendations, which were voted on by the National Psoriasis Foundation Medical Board. Findings: We identified 55 studies meeting the inclusion criteria for this review. These studies represent 77 557 unique participants of which 4534 have psoriasis. Based on the literature, we strongly recommend dietary weight reduction with a hypocaloric diet in overweight and obese patients with psoriasis. We weakly recommend a gluten-free diet only in patients who test positive for serologic markers of gluten sensitivity. Based on low-quality data, select foods, nutrients, and dietary patterns may affect psoriasis. For patients with psoriatic arthritis, we weakly recommend vitamin D supplementation and dietary weight reduction with a hypocaloric diet in overweight and obese patients. Dietary interventions should always be used in conjunction with standard medical therapies for psoriasis and psoriatic arthritis. Conclusions and Relevance: Adults with psoriasis and/or psoriatic arthritis can supplement their standard medical therapies with dietary interventions to reduce disease severity. These dietary recommendations from the National Psoriasis Foundation Medical Board will help guide clinicians regarding the utility of dietary interventions in adults with psoriatic diseases. SN - 2168-6084 UR - https://www.unboundmedicine.com/medline/citation/29926091/full_citation DB - PRIME DP - Unbound Medicine ER -